The investigation, published in Cornea, reported that clinicians should look for the following combination of symptoms when making a diagnosis: meibomian gland dropout, tarsal conjunctival scarring, irregular Marx line and keratinization of the posterior eyelid margin.3

The study found 90.6% had a history of severe ocular complications in the acute stage of the disease. Additionally, medications were found to be the most common cause of Stevens-Johnson syndrome (93.8%). Researchers noted meibum quality could not be assessed in 71.9% of patients because the glands could not be expressed. The study found partial or complete loss of the meibomian glands in either the upper or lower eyelid in all patients.3

Investigators observed the degree of meibomian gland dropout was significantly correlated with tear break-up time, meibum quality and expressibility, ocular surface staining and the presence of long-term ocular sequelae, including symblepharon and limbal stem cell deficiency.3